New mindset needed to tackle non-communicable diseases, says UN official

Countries need to change their current mindset to successfully tackle non-communicable diseases (NCDs), the head of the United Nations World Health Organization (WHO) said today, adding that governments will need to explore new approaches to prevent and treat these diseases, which have quickly become one of the most pressing issues in public health.“For ages, the mindset of public health has been geared towards the prevention and control of infectious diseases,” Director-General Margaret Chan told WHO’s Executive Board in Geneva. “It has been geared towards episodes of acute illness, and not towards long-term care or towards prevention that requires efforts well beyond the health sector. This mindset must change, and that will not be easy.”

Universal health coverage is a powerful equalizer. Changes in health status are a powerful indicator of overall social and economic well-being.

Dr. Chan stressed that because of their gradually increasing nature, NCDs are harder to tackle, and this will require a different approach from Governments and international organizations that focuses on prevention as well as treatment in cases where the disease is already advanced.

“The impact of NCDs comes in waves. What we are seeing now in much of the developing world is a first wave. This is marked by growing numbers of people with raised blood pressure, raised cholesterol, and the early stages of diabetes. The growing prevalence of obesity and overweight, seen nearly everywhere, is the warning signal that big trouble is on its way,” Dr. Chan said.

“The second wave, which is yet to come, will be much more horrific. One statistic tells the story.

Of the estimated 346 million people worldwide who suffer from diabetes, more than half are unaware of their disease status. For many of these people, the first contact with the health services will come when they start to go blind, need a limb amputation, experience renal failure, or have a heart attack,” she added.

Dr. Chan reiterated WHO’s commitment to make this issue a priority in its agenda for this year to achieve the goals set during the political declaration on NCDs in September. That declaration called for a multi-pronged campaign by governments, industry and civil society to set up by 2013 the plans needed to curb the risk factors behinds the four groups of NCDs – cardiovascular diseases, cancers, chronic respiratory diseases and diabetes.

She also emphasized that for any public health approach to be successful, governments will have to strive to end socio-economic inequality in their societies. Citing a recent report from the Organization for Economic Cooperation and Development (OECD), Dr. Chan stressed that societies with the least inequality had the best health outcomes, regardless of the levels of spending on health.

“Money alone does not buy better health. Good policies that promote equity have a better chance,” she said. “Universal health coverage is a powerful equalizer. Changes in health status are a powerful indicator of overall social and economic well-being,” she added.

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About World Health Organization (WHO)

WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends.

In the 21st century, health is a shared responsibility, involving equitable access to essential care and collective defence against transnational threats.

WHO fulfils its objectives through its core functions:

providing leadership on matters critical to health and engaging in partnerships where joint action is needed;

shaping the research agenda and stimulating the generation, translation and dissemination of valuable knowledge;

setting norms and standards and promoting and monitoring their implementation;

WHO operates in an increasingly complex and rapidly changing landscape. The boundaries of public health action have become blurred, extending into other sectors that influence health opportunities and outcomes. WHO responds to these challenges using a six-point agenda. The six points address two health objectives, two strategic needs, and two operational approaches. The overall performance of WHO will be measured by the impact of its work on women’s health and health in Africa.

1. Promoting development

During the past decade, health has achieved unprecedented prominence as a key driver of socioeconomic progress, and more resources than ever are being invested in health. Yet poverty continues to contribute to poor health, and poor health anchors large populations in poverty. Health development is directed by the ethical principle of equity: Access to life-saving or health-promoting interventions should not be denied for unfair reasons, including those with economic or social roots. Commitment to this principle ensures that WHO activities aimed at health development give priority to health outcomes in poor, disadvantaged or vulnerable groups. Attainment of the health-related Millennium Development Goals, preventing and treating chronic diseases and addressing the neglected tropical diseases are the cornerstones of the health and development agenda.

2. Fostering health security

Shared vulnerability to health security threats demands collective action. One of the greatest threats to international health security arises from outbreaks of emerging and epidemic-prone diseases. Such outbreaks are occurring in increasing numbers, fuelled by such factors as rapid urbanization, environmental mismanagement, the way food is produced and traded, and the way antibiotics are used and misused. The world’s ability to defend itself collectively against outbreaks has been strengthened since June 2007, when the revised International Health Regulations came into force.

3. Strengthening health systems

For health improvement to operate as a poverty-reduction strategy, health services must reach poor and underserved populations. Health systems in many parts of the world are unable to do so, making the strengthening of health systems a high priority for WHO. Areas being addressed include the provision of adequate numbers of appropriately trained staff, sufficient financing, suitable systems for collecting vital statistics, and access to appropriate technology including essential drugs.

4. Harnessing research, information and evidence

Evidence provides the foundation for setting priorities, defining strategies, and measuring results. WHO generates authoritative health information, in consultation with leading experts, to set norms and standards, articulate evidence-based policy options and monitor the evolving global heath situation.

5. Enhancing partnerships

WHO carries out its work with the support and collaboration of many partners, including UN agencies and other international organizations, donors, civil society and the private sector. WHO uses the strategic power of evidence to encourage partners implementing programmes within countries to align their activities with best technical guidelines and practices, as well as with the priorities established by countries.

6. Improving performance

WHO participates in ongoing reforms aimed at improving its efficiency and effectiveness, both at the international level and within countries. WHO aims to ensure that its strongest asset – its staff – works in an environment that is motivating and rewarding. WHO plans its budget and activities through results-based management, with clear expected results to measure performance at country, regional and international levels.

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> United Nations (UN).

The United Nations was established on 24 October 1945 by 51 countries committed to preserving peace through international cooperation and collective security. Today, nearly every nation in the world belongs to the UN: membership totals 192 countries.

When States become Members of the United Nations, they agree to accept the obligations of the UN Charter, an international treaty that sets out basic principles of international relations. According to the Charter, the UN has four purposes:

to maintain international peace and security;

to develop friendly relations among nations;

to cooperate in solving international problems and in promoting respect for human rights;

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